4. • A bone marrow transplant is a
procedure that infuses healthy blood-
forming stem cells into your body to
replace your damaged or diseased bone
marrow. A bone marrow transplant is
also called a stem cell transplant.
• You might need a bone marrow
transplant if your bone marrow stops
working and does not produce enough
healthy blood cells.
• Bone marrow transplants may use cells
from your own body (autologous
transplant) or from a donor (allogeneic
transplant).
Introduction •
6. Pre-Bone Marrow Transplant Evaluation.
• General health exam: This consists of a physical examination and a cancer screening tests to
evaluate your overall health.
• Biopsy: A bone marrow biopsy is done for evaluating its function and to assess for disease
involvement.
• Blood tests: There are different blood tests that you may need to undergo to know about gene
compatibility.
• Tissue typing: This is required for allogeneic patients only. It includes series of blood tests to
evaluate the compatibility or closeness of tissue between the organ donor and recipient.
• Other blood tests: There are series of tests that will be done to detect certain substances in your
blood and to evaluate your overall health. These might be done to screen you for any infectious
diseases like HIV, to check your organ function, etc.
• Imaging tests: Various tests like CT scan, MRI or PET scan may be recommended to look for any
abnormality in the organs.
• Social and psychological evaluation: These evaluations include various measures to assess
your stress, financial issues, and support by friends and family.
• Skeletal survey: These are a series of x-rays done for long bones and skulls to assess the
disease involvement in patients with multiple myeloma.
7. How the bone marrow functions
Hematopoietic stem cells are found in the
peripheral blood and the bone marrow, which is
the soft, spongy center of your bone. These stem
cells develop into all types of blood cells, including
white blood cells, red blood cells, and platelets.
• White blood cells of various kinds make up part of
your immune system for fighting infections.
• Red blood cells are responsible for carrying
oxygen throughout your body.
• Platelets clot your blood to prevent bleeding.
Stem cells are constantly being produced by your
bone marrow and will develop into the types of
cells your body needs.
8. The Bone Marrow Transplant process.
• Autologous transplant
Collection of cells
This step may take several days. At first, you will get injections of a medication that will
increase your cells. Then your doctor and his team will collect the cells through a vein
in your arm or chest. These cells will then be stored until needed.
Pre-transplant treatment
This step usually takes 5-10 days. You will get a higher dose of chemotherapy.
Sometimes, patients also receive radiation therapy.
Getting the cells back
This step is the transplant day. The process takes about 30 minutes for each dose
of cells. This is known as an infusion. Your doctor team puts the cells back into your
bloodstream via a catheter. You may have more than one infusion.
Recovery
Your doctor will closely monitor the recovery and growth of your cells and may
prescribe you antibiotics to reduce infection. They will also take care of any side
effects.
9. Complications of a bone marrow transplant
As with every surgery, the risk of complications is there and bone marrow transplant is no
exception. However, it is not always necessary that a patient develops these complications,
but it is good to be aware of it. Below are some of the common complications linked with
bone marrow transplant:
Graft versus host disease
If you have undergone an allogeneic transplant, then you are at higher risk of developing
GVHD, which is more likely to occur if the cells have been taken from an unrelated donor.
However, it may occur otherwise as well. The symptoms of GVHD may occur within the
initial month or even after a longer duration of time. These may include:
• Dry eyes
• Skin rashes
• Breathlessness and cough
• Nausea and vomiting
• Joint pains
10. The other complications may include / Risk:
• Damage to organ
• Infection
• Cancer
• Bleeding
• Problem in eyes such as cataract
• Problems in liver or kidney
• Infertility
• Cramps or numbness in arms or legs
• Breathing problems
11. • Success rate and life expectancy of a bone marrow
transplant.
With progress in medicine, the life expectancy of patients undergoing bone marrow
transplants is also improving. The success rates depend on many factors like underlying
disease, source of cells and patient's general health condition. In comparison to the last
decade, the life expectancy of patients has improved.
Success rate
Autologous transplant greater than 90%
Increased lifespan with matched
sibling donor of 1 year: 70-80%
Increased lifespan with matched
unrelated donor of 1 year: 50-60%
Life expectancy
12. Life after Bone Marrow Transplant
A bone marrow transplant can significantly improve the quality of life of the
patients. However, there are certain practices and measures that you need
to follow to live a normal life.
• Regular follow-ups: You may have to have frequent follow up with your
doctor for the initial few months after the transplant. They will keep a
check on the body's response to transplant and any complications which
may arise.
• Immunosuppressant's: As our body tends to reject the foreign body or
object. You may have to take immunosuppressant medicines to avoid the
possibility of rejection in case of allogeneic bone marrow transplant.
• Hygiene and lifestyle: Practicing good hygiene and staying active is an
excellent contributory factor for recovery. Live a healthy lifestyle by
engaging in any form of physically activity, eating a balanced diet,
avoiding smoking, etc.
13. Cost analysis of Bone Marrow Transplant,
Living with a disease that badly affects your life is an
extremely painful experience both for the patient and his
family. Getting a bone marrow transplant can certainly
improve the quality of life of the patient. The approximate
cost of bone marrow transplants in India varies between
12-15 lakh for an allogeneic transplant and 8-10 lakh for
an autologous transplant approximately.